Inside Health

LETTERS; When Parents Say No to Vaccines

Published: March 30, 2008

Parental objections to vaccines highlight the fundamental ethical dilemma inherent in all public health initiatives: the often conflicting values of seeking better societal health and preserving individual liberties.

Virtually any action taken in the name of public health -- such as mandating vaccinations -- cuts into the individual's right to make such a decision for him or herself.

The vaccine debate is further complicated because the decision to abstain from vaccination has strong negative externalities. It is not a simple decision about one's own health or one's family's health, but rather a decision that may also affect the health of those with whom the unvaccinated interact.

As a medical student and bioethics graduate student, I am particularly invested in these issues. I believe that resolutions will come at the end of debates in which we consider the common good and individual autonomy, a debate this country has had since its founding.

George L. Anesi
Cleveland, March 22, 2008

To the Editor:

It seems the parents who reject vaccines have it all figured out: they've done their ''research'' and claim to ''understand'' the risks and benefits of exempting their children from vaccines.

One question remains: Whom will they sue when their children die of preventable diseases? Themselves?

Carl Baum
New Haven, March 21, 2008

The writer, a pediatrician, is director of the Center for Children's Environmental Toxicology at Yale-New Haven Children's Hospital.

To the Editor:

When my nursing and crawling 6-month-old son went limp, refused to nurse and couldn't raise his head for 36 hours after his third diphtheria, pertussis and tetanus shot, you bet I educated myself about the true risks that accompany immunizations.

With guidance from a new doctor, I stopped all immunizations except for polio, knowing that the diseases my son would face were unlikely to kill or irreparably harm him and that if he contracted any of them, I would be able to care for him to ensure his recovery. I was simply unwilling to risk losing or injuring my son to these imperfect shots.

I relied on New York State's ''medical exemption'' as my son went from child care through college.

Until the medical community can guarantee parents that these shots won't kill or injure our children, I stand firmly behind the decision I made for my 6-month-old -- now a grown man capable of making his own medical decisions.

Laura Colby
Brooklyn, March 22, 2008

To the Editor:

Vaccines, the most cost-effective drugs ever developed, have saved the lives of countless children. Smallpox, diphtheria, whooping cough, tetanus, polio, measles, mumps, rubella and Hib meningitis have been 99 to 100 percent eradicated. But as with all drugs, there is always the possibility of rare side effects, and some children may even have a genetic predisposition for these.

As an immunologist who has a family member with Asperger's syndrome, I do not believe that this is a good rationale for exemption from vaccinations. No scientific studies have shown an increased risk of autism associated with vaccines.

If those parents who refuse to vaccinate their own children are willing to put other people's children and the elderly at risk, they must take responsibility -- and the liability that comes along with it.

If someone else's child is infected with measles (even if that child has been vaccinated but the vaccine did not provide full protection) and suffers neurological damage or death, the parents who sought an exemption should be considered negligent and liable for the resulting injury.

Axel Duwe
Martinez, Calif., March 21, 2008

The writer is a microbiologist at Diablo Valley College and a lawyer.

To the Editor:

You report that a growing number of parents in the United States are refusing to have their children vaccinated against measles because of ''personal beliefs.'' But in many developing countries, parents do not have this choice.

Factors like poverty, poor health infrastructure and a lack of information mean that families cannot get the immunizations they need. As a result, measles is still one of the leading killers of children worldwide.

Since 2001, the Measles Initiative has been working to change this situation. In collaboration with local ministries of health, the initiative has supported the vaccination of more than 500 million children in 50 countries. This has been a major contributor to the dramatic reduction in measles deaths.

It costs less than $1 to vaccinate a child. Until families everywhere have the opportunity to immunize their children against measles, children will be under threat and many more will get sick or die from this disease.

Athalia Christie
Andrea Gay
Washington, March 24, 2008

The writers are, respectively, a senior technical adviser for the American Red Cross and the executive director of Children's Health, United Nations Foundation. Their organizations are founding members of the Measles Initiative.